What are the medications for meningitis?

From the Guidelines

Meningitis is typically treated with antibiotics, with the specific medication depending on the cause, and immediate treatment with broad-spectrum antibiotics like ceftriaxone (2g IV every 12 hours) and vancomycin (15-20 mg/kg IV every 8-12 hours) is crucial until the specific bacteria is identified, as recommended by the UK Joint Specialist Societies guideline 1.

Treatment Overview

The treatment of meningitis involves the use of antibiotics, with the specific medication depending on the cause of the infection.

• For bacterial meningitis, immediate treatment with broad-spectrum antibiotics is crucial until the specific bacteria is identified.
• Viral meningitis often resolves without specific treatment, though acyclovir (10 mg/kg IV every 8 hours) may be used if herpes virus is suspected.
• Fungal meningitis requires antifungal medications like amphotericin B (0.7-1.0 mg/kg/day IV) for several weeks.

Antibiotic Treatment

The UK Joint Specialist Societies guideline recommends the following antibiotic treatments:

• 2 g ceftriaxone intravenously (IV) every 12-h or 2 g cefotaxime IV every 6-h for patients with suspected meningitis or meningococcal sepsis 1.
• If the patient has been to a country where penicillin-resistant pneumococci are prevalent, IV vancomycin 15-20 mg/kg should be added 12-hourly 1.

Corticosteroid Treatment

Dexamethasone (10 mg IV every 6 hours) should be started on admission, either shortly before or simultaneously with the antibiotics, as recommended by the UK Joint Specialist Societies guideline 1.

• If pneumococcal meningitis is confirmed, or thought probable, dexamethasone should be continued for 4 days 1.
• If another cause of meningitis is confirmed, or thought probable, the dexamethasone should be stopped 1.

Supportive Care

Supportive care, including pain management with acetaminophen or ibuprofen, adequate hydration, and rest, is important for all types of meningitis.

• Prompt treatment is essential as meningitis can be life-threatening, with bacterial forms being particularly dangerous and requiring immediate medical attention to prevent serious complications like brain damage, hearing loss, or death.

From the FDA Drug Label

1. 3 Bacterial Meningitis (Pediatric Patients 3 Months of Age and Older Only) Meropenem for injection is indicated for the treatment of bacterial meningitis caused by Haemophilus influenzae,Neisseria meningitidis and penicillin-susceptible isolates of Streptococcus pneumoniae. The medication for meningitis is meropenem (IV), which is effective against Haemophilus influenzae, Neisseria meningitidis, and penicillin-susceptible isolates of Streptococcus pneumoniae 2.

• Key points:
  • Meropenem (IV) is indicated for bacterial meningitis in pediatric patients 3 months of age and older.
  • Effective against specific bacteria, including Haemophilus influenzae, Neisseria meningitidis, and penicillin-susceptible isolates of Streptococcus pneumoniae.

From the Research

Medications for Meningitis

The following medications are used to treat meningitis:

• Ceftriaxone: a cephalosporin antibiotic that can be administered in a single daily dose 3, 4
• Vancomycin: an antibiotic that can be used to treat bacterial meningitis, especially in cases where other antibiotics are not effective 5
• Cefotaxim: a third-generation cephalosporin that can be used in combination with vancomycin as a first-line treatment for bacterial meningitis in infants and children 6
• Amoxicillin: an antibiotic that can be used to treat listeriosis, a type of bacterial meningitis 6
• Gentamycin: an aminoglycoside antibiotic that can be used in combination with amoxicillin to treat listeriosis 6
• Cotrimoxazole: an antibiotic that can be used in combination with amoxicillin to treat listeriosis 6
• Rifampicin: an antibiotic that can be used in combination with other antibiotics to treat bacterial meningitis 6

Dosage and Administration

The dosage and administration of these medications vary depending on the specific condition being treated and the patient's age and weight. For example:

• Ceftriaxone can be administered in a single daily dose of 50 mg/kg (maximum 4 g/d) for adults 3
• Ceftriaxone can be administered in a single daily dose of 100 mg/kg for infants and children 4, 6
• Vancomycin can be administered intravenously, with therapeutically effective levels attained in the cerebrospinal fluid 5
• Cefotaxim can be administered in a dose of 300 mg/kg per day for infants and children 6
• Amoxicillin can be administered in a dose of 3 weeks, associated with gentamycin or cotrimoxazole for listeriosis 6